Africa's fake pharmaceuticals problem

Benin's Adjegounle market is a kingdom of street pharmacies, where 'cure'
meets 'kill' on a regular basis.

A few kilometres from Benin's conference centre where France's former president Jacques Chirac introduced a global campaign against counterfeit drugs this week, hundreds of vendors make brisk business peddling all types of bogus pharmaceuticals.

Adjegounle, the "drugs" district that spans over 1,000 square metres (more than 10,000 square feet) in the heart of Dantokpa, the largest market in the Beninese metropolis, is always packed, even on Sundays.

Aisha, 31, sits under sweltering tropical heat, sweat dripping down her face, behind her stall on which she displays all kinds of fake drugs that she is hawking.

"How can you stop us when we have done nothing wrong?" she challenged.

"Every day, I leave the market with an average of 600,000 FCFA (£839). I support my entire family," said Aisha, apparently unperturbed by the deaths and devastation that has been blamed on adulterated drugs.

At least 250 deaths and 340 cases of chronic illnesses linked to such drugs were recorded between April 2007 and June 2008 by the National Medical Centre and University of Cotonou, according to a medical thesis.

In the small, impoverished west African country where more than 6.8 percent of the population is jobless and where the informal sector accounts for over 80 of the gross domestic product in urban areas, inhabitants say they make do with what is within their means.

"For us, it's an advantage. Here I buy a box of Bristopen (an antibiotic) at 2,500 FCFA (£3.50) while in the pharmacy it costs 6,000 FCFA. Same for anti-malaria drugs: here I pay 1,500 FCFA compared to 3,000 FCFA in pharmacy," said Jean Soton, one of Aisha's clients.

The government appears absent and powerless to stamp out the scourge of "street pharmacies", as they're called here.

"We mostly supply to Ghana or neighbouring Nigeria and pay customs duty like any other product.

"Once on the market, we pay 72,000 FCFA (£105) in licence fees to the municipality and we have vending permits from Sogema (the market management agency)," said Cherifath Adimi, a pharmacist in Adjegounle for the last 42 years.

"There are even NGOs who come to sell drugs. We sometimes source from official pharmacies. We are not doing anything illegal," she said.

Counterfeit medicine networks have been accused of taking advantage of poor or non-existent drug regulatory systems in Africa - and elsewhere - to dump drugs with little or no active ingredient in the continent.

"The lack of facilities and infrastructure has created a breeding ground for this kind of obscene practice, with the consequent failure to implement existing laws," said Sadikou Alao, advisor to the Benin College of Pharmacists.

According to the World Health Organisation (WHO), some 200,000 deaths could be prevented each year had it not been for the use of counterfeit drugs.

The WHO estimates that fake medicines represent 10 per cent of the global pharmaceutical industry at some 45 billion euros (£41.2 billion).

In 2006, 300 deaths alone were recorded in the central American country of Panama as a result of using counterfeit drugs. Nearly 100 babies died in Nigeria last year after being administered with fake pain-killing paracetamol syrup.

Chirac's initiatiave, introduced here in Benin's seat of government on Monday, aims at raising awareness among political leaders around the world to work against the proliferation of such fake pharmaceuticals, a practice he described as a "crime".

"Of all the inequalities, the most painful is the inequality in health," said Chirac, after he met leaders of Benin, Burkina Faso, Central Africa Republic, Niger, the Republic of Congo, Senegal and Togo.

"Do not tell me that it is not a crime!" he said citing WHO statistics indicating that an estimated one in every four medicines sold in developing countries is a counterfeit.